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M. Takeda
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P1.03 - Chemotherapy/Targeted Therapy (ID 689)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.03-005 - Phase 2 Study of Ceritinib in Patients with ALK+ NSCLC with Prior Alectinib Treatment in Japan: ASCEND-9 (ID 8417)
09:30 - 09:30 | Author(s): M. Takeda
- Abstract
Background:
ALK inhibitors are a standard of care for ALK-positive metastatic NSCLC and several ALK inhibitors are currently available. Alectinib is one of the recommended therapies as 1[st] line treatment for ALK-positive metastatic NSCLC in Japan based on robust progression-free survival (PFS) prolongation and favorable safety profile. However, even with treatment with alectinib, these cancers eventually progress after acquiring resistance against alectinib. Therefore, which drug should be chosen after alectinib is relevant clinical question. Recently, ceritinib, which is a highly selective oral ALK inhibitor, has demonstrated superior activity compared to chemotherapy in the 1[st] line setting for patients with ALK-positive metastatic NSCLC (ASCEND-4, Soria et al. Lancet 2017). It also showed clinically meaningful benefit in patients who failed to prior ALK inhibitor treatment including alectinib (Nishio et al. J Thorac Oncol 2015). In this study, we tried to evaluate efficacy and safety of ceritinib in ALK-positive metastatic NSCLC patients who progressed on alectinib treatment.
Method:
ASCEND-9 (NCT02450903) is a single-arm, open-label, multicenter, phase 2 study of ceritinib 750 mg/day (fasted) in adult patients with ALK+ (Vysis ALK Break Apart FISH Probe kit test), stage IIIB/IV NSCLC previously treated with alectinib and had subsequent disease progression. Other key inclusion criteria are ≥ 1 measurable lesion per RECIST 1.1 and WHO PS 0-1. Patients must have received previous treatment with alectinib, but prior crizotinib and/or up to 1 chemotherapy regimen are allowed. Patients with asymptomatic CNS metastases are eligible. Ceritinib may be continued beyond RECIST-defined PD. Primary endpoint is investigator assessed-overall response rate (ORR) per RECIST 1.1. Secondary endpoints include disease control rate (DCR), time to response (TTR), duration of response (DOR), PFS and safety. Biomarkers are evaluated for exploratory purpose.
Result:
Twenty patients were enrolled at 10 centers in Japan from Aug 2015 to Feb 2017. At present, the study is underway, and the results including ORR, DCR, TTR, DOR, PFS, safety and exploratory biomarker data will be presented at the 2017 WCLC.
Conclusion:
Section not applicable.
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P1.07 - Immunology and Immunotherapy (ID 693)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Immunology and Immunotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.07-010 - Peripheral Blood Biomarkers Associated with Clinical Outcome in Non–Small Cell Lung Cancer Patients Treated with Nivolumab (ID 8547)
09:30 - 09:30 | Author(s): M. Takeda
- Abstract
Background:
Targeting of the immune system has been found to confer clinical benefit for patients with some types of advanced solid tumor. Given that only a limited number of patients experience a durable response, whereas all those treated are at risk for specific immune side effects, the identification of individuals who are most likely to benefit from nivolumab and similar agents is an important clinical goal. We have now examined the possible impact of clinical parameters determined in the routine laboratory setting—including peripheral blood cell counts such as ANC, absolute lymphocyte count (ALC), absolute monocyte count (AMC), and absolute eosinophil count (AEC)—on outcome in patients with advanced or recurrent NSCLC treated with nivolumab.
Method:
A total of 134 patients with advanced or recurrent NSCLC treated with nivolumab was analyzed retrospectively. Univariable and multivariable analyses were performed to evaluate the relation between survival and peripheral blood parameters measured before treatment initiation, including absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute monocyte count, and absolute eosinophil count (AEC) as well as serum C-reactive protein and lactate dehydrogenase levels. Progression-free survival (PFS), overall survival (OS), and response rate were determined. We further evaluated the association of these factors and the expression level of PD-L1 of tumor tissue.
Result:
Among variables selected by univariable analysis, a low ANC, high ALC, and high AEC were significantly and independently associated with both better PFS (P = 0.001, P = 0.04, and P = 0.02, respectively) and better OS (P = 0.02, P = 0.04, and P = 0.003, respectively) in multivariable analysis. Categorization of patients according to the number of favorable factors revealed that those with only one factor had a significantly worse outcome compared with those with two or three factors. Median PFS was 209, 87, and 42 days and the response rate was 43.5%, 27.1%, and 5.9% in patients with three, two, or one of the three favorable factors, respectively. The association between survival factors and the expresssion of PD-L1 in tumor tissue will be presented at the conference as well.
Conclusion:
A baseline signature of a low ANC, high ALC, and high AEC was associated with a better outcome of nivolumab treatment, with the number of favorable factors identifying subgroups of patients differing in survival and response rate.
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P2.03 - Chemotherapy/Targeted Therapy (ID 704)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.03-058a - T790M-Selective EGFR-TKI Combined with Dasatinib as an Optimal Strategy for Overcoming EGFR-TKI Resistance in T790M-Positive NSCLC (ID 9970)
09:30 - 09:30 | Author(s): M. Takeda
- Abstract
Abstract not provided
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P2.07 - Immunology and Immunotherapy (ID 708)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Immunology and Immunotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.07-021 - A Checkpoint Molecule B7-H3 as a Novel Immune Therapy Target for Non-Small Cell Lung Cancer (NSCLC) (ID 8598)
09:30 - 09:30 | Author(s): M. Takeda
- Abstract
Background:
Anti-PD-1 immune therapy improved survival in NSCLC, whereas some patients were not responding to this treatment, indicating the requirement of alternative strategies for these patients. B7-H3, an immune checkpoint molecule, has known to be expressed in some cancer cells including NSCLC. In this study, we examined the therapeutic potential of targeting B7-H3 using a mouse model, also elucidated the expression levels of B7-H3 on NSCLC tumor cells.
Method:
Pan02 murine cancer cells were inoculated in syngeneic mice, and anti-tumor efficacy of anti-B7-H3, anti-PD-L1 antibodies were evaluated. T-cell expression of IFN gamma was evaluated in the spleen and tumor infiltrating lymphocytes using flow-cytometer. B7-H3 expression on tumor cells in patients with NSCLC (n=69) was evaluated by immunohistochemistry.
Result:
In the mouse model study, the treatment with anti-B7-H3 antibody significantly prevented the tumor-growth as compared to isotype antibody. The numbers of CD4+ and CD8+ T-cells infiltrated in the tumor significantly increased following treatment with anti-B7-H3 antibody. Importantly, depletion of CD8+ T-cells cancelled the anti-tumor effect of anti-B7-H3 antibody treatment, indicating that the blockade of B7-H3 potentiates anti-tumor CD8+ T-cell responses. In fact, CD8+ T-cell expressions of IFN gamma in response to tumor cells were improved when mice were treated with anti-B7-H3 antibody. Furthermore, combination with anti-B7-H3 and anti-PD-L1 antibody treatment showed synergic effect in inhibiting tumor-growth. The expressions of B7-H3 were evident on NSCLC tumors, which consists 62% of NSCLC patients.
Conclusion:
Anti-B7-H3 antibody exhibited CD8+ T-cell-mediated anti-tumor effects in the mouse model study. B7-H3 was aberrantly expressed in NSCLC tumor cells. Anti-B7-H3 antibody or its combination with anti-PD-1 antibody is suggested to be effective for patients with NSCLC. Figure 1
